Publication: Diabetik hastalarda hepatit C virüs enfeksiyonu sıklığı
Abstract
Diabetik hastalarda hafif ve asemptomatik enzim yüksekliği sık görülen bir patolojidir ve çoğunlukla yağlı karaciğere bağlanmaktadır. Diabetli hastaların, hastalıkları süresince daha sık tıbbi işleme maruz kaldıkları bilinmektedir. Son zamanlarda diabet ve HCV enfeksiyonu arasında bir ilişki olduğu öne sürülmektedir. Bu çalışmadaki amacımız diabetes mellitus hastalarında HCV enfeksiyonu sıklığını saptamak ve HCV ile hastalık süresi, tipi, majör cerrahi girişim ve kan nakli ilişkisini araştırmaktır. Çalışmaya diabet tanısı konulmuş 85 hasta (60 kadın, 25 erkek, ortalama yaş 62.5±10.9) alındı. Hastaların 5'i tip 1, 80'i tip 2 diabet ile izlenmekteydi. Tüm olgulara içiçe-PZR ile HCV-RNA tayini yapıldı. Kontrol gurubu olarak hastanemiz kan merkezinin donör sonuçları kullanıldı. Tüm olguların 8/85'inde (%9.4) HCV-RNA pozitifliği saptandı. Bu sonuç kontrol gurubundaki %1 oranına göre anlamlı derecede yüksekti (p< 0.0001). HCV-RNA pozitif olan 8 hastanın 6'sında, negatif olan 77 hastanın ise sadece 2'sinde ALT değerleri yüksekti (p<0.0001). HCV-RNA pozitif olan olguların hiçbirinde kan nakli öyküsü yoktu, 5 hastada ameliyat ve hastaların tümünde diş tedavisi öyküsü vardı. Bu 8 hastanın tümü tip 2 diabet olup ortalama hastalık süreleri 11.1 yıldı. Sonuç olarak diabetik hasta gurubunda HCV enfeksiyonu normalden daha sıktır. Bu durum özellikle tip 2 diabette belirgindir. HCV-RNA pozitif olan olguların çoğunluğunda serum ALT düzeyi yüksekliği saptanmıştır
Mild asymptomatic elevation of serum aminotransferases is a common finding in diabetic patients and often attributed to fatty infiltration of liver. It is well known that diabetic patients receive much more medical interventions compared with healthy persons. Recently a correlation between diabetes mellitus and hepatitis C virus infection had been suggested. In this study we planned to access the prevalence of hepatitis C infection in diabetic patients and the relation of hepatitis C virus infection with type, duration, and treatment of diabetes or the history of major surgical procedures and blood transfusion. Eighty five diabetic patients (60 females, 25 males, mean age 62.5±10.9) enrolled in the study group. Five patients were classified as type 1 and 80 patients as type 2 diabetes. HCV-RNA was detected by nested PCR method. Healthy blood donors were used as control group. Eight patients over 85 (9.4%) were found to be HCV-RNA positive, being significantly higher compared with the 1% rate of control group (p< 0.0001). Serum alanin transaminase levels were elevated in 6 patients over 8 with a positive HCV-RNA result, while only in 2 patients over 77 who were HCV-RNA negative (p<0.0001). None of the HCV-RNA positive patients had a history of blood transfusion, while 5 had a major operation and all had dental treatment previously. All HCV-RNA positive patients were type 2 diabetics with a mean disease duration of 11.1 years. As a result the prevalence of HCV infection is significantly higher in diabetic patients compared with healthy controls and more prevalent in type 2 diabetics. Increased ALT levels may be a marker of HCV infection.
Mild asymptomatic elevation of serum aminotransferases is a common finding in diabetic patients and often attributed to fatty infiltration of liver. It is well known that diabetic patients receive much more medical interventions compared with healthy persons. Recently a correlation between diabetes mellitus and hepatitis C virus infection had been suggested. In this study we planned to access the prevalence of hepatitis C infection in diabetic patients and the relation of hepatitis C virus infection with type, duration, and treatment of diabetes or the history of major surgical procedures and blood transfusion. Eighty five diabetic patients (60 females, 25 males, mean age 62.5±10.9) enrolled in the study group. Five patients were classified as type 1 and 80 patients as type 2 diabetes. HCV-RNA was detected by nested PCR method. Healthy blood donors were used as control group. Eight patients over 85 (9.4%) were found to be HCV-RNA positive, being significantly higher compared with the 1% rate of control group (p< 0.0001). Serum alanin transaminase levels were elevated in 6 patients over 8 with a positive HCV-RNA result, while only in 2 patients over 77 who were HCV-RNA negative (p<0.0001). None of the HCV-RNA positive patients had a history of blood transfusion, while 5 had a major operation and all had dental treatment previously. All HCV-RNA positive patients were type 2 diabetics with a mean disease duration of 11.1 years. As a result the prevalence of HCV infection is significantly higher in diabetic patients compared with healthy controls and more prevalent in type 2 diabetics. Increased ALT levels may be a marker of HCV infection.